{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T02:08:54Z","timestamp":1783908534441,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Access to the frontal sinus after receiving angled Draf 2a frontal sinusotomy remains challenging, while adequate postoperative irrigation is essential in managing chronic inflammatory sinus disease. This study compared frontal sinus irrigation distribution between the angled Draf 2a and Carolyn's window approaches, a modification of Draf 2a which removes the nasofrontal beak by drilling to permit direct 0\u00b0 endoscopic access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fresh human cadaver heads underwent sequential dissection with angled Draf 2a followed by Carolyn's window approach. Each cavity was irrigated using a 250\u2009mL high\u2010pressure squeeze bottle filled with 1\/1000 10% fluorescein\u2010labeled water in the Frankfort horizontal position. Fluid irrigation was recorded using an endoscope placed within the frontal sinus. Blinded grading of fluid distribution was performed using a 0\u20134 scale: 0 (nasal cavity only), 1 (frontal recess), 2 (medial half), 3 (lateral half), and 4 (complete lavage). Scores were compared between two surgical approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight cadaveric specimens (16 frontal sinuses) were evaluated. Compared with angled Draf 2a frontal sinusotomy, Carolyn's window approach achieved a greater distribution: grade 1 (50.0% vs. 0%), grade 2 (31.3% vs. 0%), grade 3 (6.3% vs. 43.8%), and grade 4 (12.5% vs. 56.3%). The median (IQR) distribution grade following angled Draf 2a frontal sinusotomy was 1.5 (1, 2), and 4 (3, 4) for the Carolyn's window approach (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Carolyn's window significantly enhances frontal sinus irrigation compared to angled Draf 2a by improving access and distribution. This technique is robust for enhancing postoperative topical therapy in chronic frontal sinus disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70515","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T01:45:16Z","timestamp":1773971116000},"page":"3410-3415","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Frontal Sinus Irrigation After Draf 2a: Carolyn's Window Versus Angled Frontal Sinusotomy"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5911-674X","authenticated-orcid":false,"given":"Napamon","family":"Chantarapitak","sequence":"first","affiliation":[{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center King Chulalongkorn University  Bangkok Thailand"},{"name":"Department of Otolaryngology, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Clinical Sciences Program, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Department of Otorhinolaryngology, Bhumibol Adulyadej Hospital, Directorate of Medical Services, The Royal Thai Air Force  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-4525","authenticated-orcid":false,"given":"Stephen J.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Biostatistics Excellence Centre, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"The Kirby Institute Univerity of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7537-4718","authenticated-orcid":false,"given":"Kornkiat","family":"Snidvongs","sequence":"additional","affiliation":[{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center King Chulalongkorn University  Bangkok Thailand"},{"name":"Department of Otolaryngology, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2681-2958","authenticated-orcid":false,"given":"Dichapong","family":"Kanjanawasee","sequence":"additional","affiliation":[{"name":"Center of Research Excellence in Allergy and Immunology, Faculty of Medicine, Siriraj Hospital Mahidol University  Bangkok Thailand"},{"name":"Biodesign Innovation Center, Department of Parasitology, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9787-6767","authenticated-orcid":false,"given":"Wirach","family":"Chitsuthipakorn","sequence":"additional","affiliation":[{"name":"Center of Excellence in Otolaryngology, Head and Neck Surgery Rajavithi Hospital  Bangkok Thailand"},{"name":"College of Medicine Rangsit University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8878-2905","authenticated-orcid":false,"given":"Minh P.","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Medicine and Pharmacy Hue University  Hue Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4816-2661","authenticated-orcid":false,"given":"Prem","family":"Wungcharoen","sequence":"additional","affiliation":[{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center King Chulalongkorn University  Bangkok Thailand"},{"name":"Department of Otolaryngology, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1930-3242","authenticated-orcid":false,"given":"Jesada","family":"Kanjanaumporn","sequence":"additional","affiliation":[{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center King Chulalongkorn University  Bangkok Thailand"},{"name":"Department of Otolaryngology, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9666-5987","authenticated-orcid":false,"given":"Supinda","family":"Chusakul","sequence":"additional","affiliation":[{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center King Chulalongkorn University  Bangkok Thailand"},{"name":"Department of Otolaryngology, Faculty of Medicine Chulalongkorn University  Bangkok 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